Читать книгу Biological Mechanisms of Tooth Movement - Группа авторов - Страница 16

For millennia, we were unable to understand why teeth can be moved by finger pressure, as advocated by Celsus around the dawn of the Common Era, but it was working. Indeed, our ancestors were keenly aware of malocclusions, and the ability to push teeth around by mechanical force. The modern era in dentistry began in 1728 with the publication of the first comprehensive book on dentistry by Fauchard. He described a procedure of “instant orthodontics,” whereby he aligned ectopically erupted incisors by bending the alveolar bone. A century‐and‐a‐half later, in 1888, Farrar tried to explain why teeth might be moved when subjected to mechanical loads. His explanation was that the teeth move either because the orthodontic forces bend the alveolar bone, or they resorb it. The bone resorption idea of Farrar was proven by Sandstedt in 1901 and 1904, with the publication of the first report on the histology of orthodontic tooth movement. Histology remained the main orthodontic research tool until and beyond the middle of the twentieth century. At that time medical basic research began evolving at an increasing pace, and newly developed research methods were being adapted by investigators in the various fields of dentistry, including orthodontics; Farrar’s assumption that orthodontic forces bend the alveolar bone was proven to be correct, and the race was on to unravel the mystery of the biology of tooth movement. During the second half of the twentieth century, tissues and cells were challenged and studied in vitro and in vivo following exposure to mechanical loads. The main fields of research that have been plowed by these investigations include histochemistry, immunohistochemistry, immunology, cellular biology, molecular biology, and molecular genetics. From this broad research effort it has been concluded that teeth can be moved because cells around their roots are enticed by the mechanical force to remodel the tissues around them. This conclusion has opened the door for quests aimed at discovering means to recruit the involved paradental cells to function in a manner that would result in increased tooth movement velocity. The means tried in these investigations have been pharmaceutical, physical, and surgical. In all these categories, experimental outcomes proved that the common denominator, the cell, is indeed very sensitive to most stimuli, physical and chemical. Hence, the way ahead for orthodontic biological researchers is clear. It is a two‐lane highway, consisting of a continuous stream of basic experiments aiming at uncovering additional secrets of tissue and cellular biology, alongside a lane of trials exploring means to improve the quality of orthodontic care. Gazing toward the horizon, these two lanes seem to merge.

Biological research has exposed differences between individuals based on molecular outlines and entities. In people who possess similar facial features and malocclusions, this variability, which should be reflected in the diagnosis, may require the crafting of treatment plans that address the individual molecular peculiarities. These differences may be due to genetic and/or environmental factors and should be addressed by a personalized orthodontic treatment plan, adapted to the biological profile and needs of each individual patient.